Protecting your eyes – and those of your team and patients – has a key part to play in the delivery of safe dental care. In this article, we focus on why optimising and protecting your sight and those around you is vital.
As well as manual dexterity, fine-tuned diagnostic skills and the ability to actively listen, dental care also demands excellent eyesight. This is particularly important when it comes to your near vision; after all, the oral cavity is a small and confined space in which to work. Whether it is a scale and polish or a more complex and finer endodontic treatment, there is a constant demand for focussed, precise eyesight. It is prudent therefore to take the time to keep your eyes in the best of health by attending regular appointments with an optometrist and taking precautions to protect your vision when you are working.
The number of people living with a loss of sight in the UK is rising. Every day 250 people start losing their sight, and this is set to double by 2050. Yet only 2% of all UK medical research funding is currently directed at eye disease. While new and improved treatments need to be found to combat this level of sight loss, we should be doing more to protect the sight we have.1
As well as short and long sightedness and astigmatisms, common eye problems include presbyopia, floaters (tiny spots or specks that float across the field of vision) and dry eyes (when tear glands cannot make enough tears, or produce poor quality tears). Additionally, the risk of eye diseases increases as we get older and include the occurrence of macular-degeneration, cataracts and glaucoma.2
In 2018, Dentists’ Provident paid nearly £200,000 in claims for eye conditions including degenerative disorders, glaucoma, visual impairments and retinal detachment. A recent case also demonstrated the personal impact of these claims, when a middle-aged practice owner member had to stop practising because of progressive loss of sight despite potentially many years left of their career.2a
The latest research to save our sight
Research by Moorfields Eye Hospital, that looked at data over a ten year period, found increases in the three main causes of sight loss and reduced vision in England and Wales. In the study, over fifty per cent of people certified as blind or partially sighted developed the condition through degeneration of the macula (mainly due to age). Glaucoma and diabetic retinopathy were the next most common causes , with the latter being the main cause in the over 65s.3 A more recent smaller study found there might be a new technique that treats the main cause of permanent blindness due to glaucoma.3a
As we reach middle age, our sight alters. It can become more difficult to focus on near objects – and this presbyopia (long-sightedness), caused by normal ageing, usually begins at around 40. Premature presbyopia can however occur in people who have a job that requires a lot of close-up work, like dental professionals.4
Dental professional’s eyes
Over-reaching, in order to see inside your patient’s mouth could occur more frequently due to poor eyesight, and this in turn can lead to musculoskeletal disorders (MSDs). And as we know work-related MSDs, such as neck and back pain, are very common among dental professionals,5 with research suggesting it is also one of the main causes of ill-health related premature retirement.6 Wearing loupes is accepted practice in surgery for seeing finer detail more clearly while trying to maintain good posture.7 A study of ergonomics investigating optometric correction in relation to head and neck kinematics revealed that prismatic glasses may minimise the risk of neck pain by reducing head and neck flexion. 8
How many dental professionals actually invest the time in attending regular eye tests? And how often is advisable?
A summary of research into the eye care habits of UK dentists published in 2007 concluded that ‘although the vast majority of respondents attended for eye examination every two years, not all did. In view of the subtle changes in vision that may not be apparent to the individual, with time, this is less than ideal.’ 9 A more recent study looked at the eyesight of the staff in a dental school and worryingly found that 8% were unsure if their eyesight was satisfactory for the level of work a dentist is required to undertake.10
Optometrists recommend, especially for those over 40s, that you have your eyes tested every two years, or as often as they personally recommend for you. They not only look at your ability to see, and the health of your eyes, but also, like you do yourselves for your patients, they conduct a thorough medical history check to ensure there is no evidence of family history of eye disease or systemic problems, such as diabetes.11
Dentistry is a profession with its fair share of hazards and this includes serious injury to anyone’s eyes when they are in the surgery. So it is prudent that specific health and safety standards in practice include avoiding any potential injury for staff and patients alike. In addition, DCPs and dentists must be vigilant in wearing protective equipment to ensure their own safety and to remain healthy and active in their profession.11 It is also important to look after your team and patients’ eyes too. The possibility for an injury exists for everyone and, interestingly, with the advent of the hugely efficient four-handed dentistry, there is an increased risk of patient eye trauma with instruments being passed over the patient from dentist to nurse, and vice versa. Additionally, aerosols, chemicals and curing lights are very often in close proximity to a patient’s eyes, and they too could be potential hazards.12
HTM 01-05 maintains that: ‘During cleaning procedures, there is a risk of contaminated fluids splashing onto the face and into the eyes. Therefore, the dental team should ensure protection of their mucosa from splashes and other contaminated fragments that may escape during these procedures.’ Additionally, it suggests: ‘Spectacles do not provide sufficient eye protection unless specifically designed for the purpose. It is advisable to wear a visor or face shield over spectacles; this gives added protection for prescription glasses.’13
By ensuring protocols are in place to prevent incidents happening – and by adhering to recommendations for both clinician and patient – your practice should be well equipped to minimise risk. Should an incident occur, however, it is wise that each member of the dental team understands how to handle a medical emergency; it’s an expectation of the GDC that all registrants are trained in dealing with them and possess up-to-date evidence of their capability too.14
Regular check-ups to monitor your eyesight have been shown to be vital in order to review your sight and eye health, all supporting your ability to practise effectively. As such staff and patients alike should be issued with adequate protective eyewear, and it’s always wise to follow best practice in the handling of dental instruments and materials also.
References available on request.
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